全腹腔镜下三角吻合治疗胃癌近期疗效的Meta分析

Delta-shaped anastomosis versus Billroth I anastomosis in laparoscopic distal gastrectomy for gastric cancer： A Meta analysis of short-term curative effect

目的从循证医学角度系统评价全腹腔镜下三角吻合（intracorporeal Billroth I anastomosis，ICBI）治疗胃癌的有效性、安全性及近期疗效。方法检索收集截止至2015年11月发表的比较ICBI和腹腔镜辅助毕I式吻合术（extracorporeal Billroth I anastomosis，ECBI）治疗胃癌的中、英文文献，利用RevMan5．3软件进行Meta分析。结果共纳入11篇文献，共计2020例胃癌患者，其中ECBI组1169例，ICBI组851例。Meta分析结果显示，与ECBI组相比，ICBI组在手术时间、切缘距离以及术后总体并发症、吻合口相关并发症方面相比差异均无统计学意义（均P〉0．05）。但ICBI组的术中出血量较ECBI组减少，淋巴结清扫数目更多，术后胃肠道功能恢复更快，使用止痛药次数更少，住院时间更短（均P〈0．05）。结论ICBI治疗胃癌是安全有效的，具有良好的近期疗效。

Objective systematically evaluate the efficacy, safety and recent curative effects of deha-shaped anastomosis in totally laparoscopic distal gastrectomy （ ICBI ） for gastric carcinoma. Methods Literatures in English and Chinese comparing ECBI and ICBI published up to November 2015 were searched from international and national online databases. Meta-analysis was conducted by Review Manager 5.3 soft ware. Results There are eleven studies involved, with 2020 gastric cancer patients, including, 1 169 ECBI cases and 851 ICBI cases. Meta-analysis showed that there was no significant statistical differences between ECBI group and ICBI group in operative time, resection margin length, overall postoperative complications and anastomosis-related complications. （ all P 〉 0. 05 ）. When compared to ECBI, the estimated blood loss was significantly less in ICBI, and ICBI with more retrieved lymph nodes, faster recovery of gastrointestinal function, less use of painkiller and shorter postoperative hospital stay （ all P 〈 0.05）. Conclusion ICBI is safe and feasible in treatment of gastric cancer, and has a good short-term effect.